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The Treatment of Joint Pain with Intra-articular Pulsed Radiofrequency
BACKGROUND: The intra-articular (IA) application of pulsed radiofrequency (PRF) for pain in small and large joints represents a recent development that has proven to be effective in many cases. We performed a retrospective study of 89 such procedures in 57 consecutive patients with chronic articular...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Kowsar
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833041/ https://www.ncbi.nlm.nih.gov/pubmed/24282777 http://dx.doi.org/10.5812/aapm.10259 |
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author | Schianchi, Pietro M Sluijter, Menno E Balogh, Susan E |
author_facet | Schianchi, Pietro M Sluijter, Menno E Balogh, Susan E |
author_sort | Schianchi, Pietro M |
collection | PubMed |
description | BACKGROUND: The intra-articular (IA) application of pulsed radiofrequency (PRF) for pain in small and large joints represents a recent development that has proven to be effective in many cases. We performed a retrospective study of 89 such procedures in 57 consecutive patients with chronic articular pain. OBJECTIVES: The aim of this retrospective study is to evaluate the effectiveness of intraarticular PRF in a group of 57 consecutive patients with chronic joint pain. PATIENTS AND METHODS: Patients with intractable joint pain for more than 6 months were treated with IA PRF 40-45V for 10-15 min in small joints and 60V for 15 min in large joints using fluoroscopic confirmation of correct needle position. A total of 28 shoulders, 40 knees, 10 trapezio-metacarpal, and 11 first metatarso-phalangeal joints were treated. Results were evaluated at 1, 2, and 5 months. The procedure was repeated after 1 month in 10 patients with initial suboptimal results. Success was defined as a reduction of pain score by at least 50%. RESULTS: All groups showed significant reductions in pain scores at all three follow-up visits. Success rates were higher in small joints (90% and 82%, respectively) than large ones (64% and 60%, respectively). Interestingly, IA PRF was successful in 6 out of 10 patients who had undergone previous surgery, including 3 with prosthetic joint replacement and in 6 of the 10 repeated procedures. There were no significant adverse effects or complications. CONCLUSIONS: IA PRF induced significant pain relief of long duration in a majority of our patients with joint pain. The exact mechanism is unclear, but may be related to the exposure of immune cells to low-strength RF fields, inducing an anti-inflammatory effect. The success rate appears to be highest in small joints. We recommend additional research including control groups to further investigate and clarify this method; our data suggest that it may represent a useful modality in the treatment of arthrogenic pain. |
format | Online Article Text |
id | pubmed-3833041 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Kowsar |
record_format | MEDLINE/PubMed |
spelling | pubmed-38330412013-11-26 The Treatment of Joint Pain with Intra-articular Pulsed Radiofrequency Schianchi, Pietro M Sluijter, Menno E Balogh, Susan E Anesth Pain Med Research Article BACKGROUND: The intra-articular (IA) application of pulsed radiofrequency (PRF) for pain in small and large joints represents a recent development that has proven to be effective in many cases. We performed a retrospective study of 89 such procedures in 57 consecutive patients with chronic articular pain. OBJECTIVES: The aim of this retrospective study is to evaluate the effectiveness of intraarticular PRF in a group of 57 consecutive patients with chronic joint pain. PATIENTS AND METHODS: Patients with intractable joint pain for more than 6 months were treated with IA PRF 40-45V for 10-15 min in small joints and 60V for 15 min in large joints using fluoroscopic confirmation of correct needle position. A total of 28 shoulders, 40 knees, 10 trapezio-metacarpal, and 11 first metatarso-phalangeal joints were treated. Results were evaluated at 1, 2, and 5 months. The procedure was repeated after 1 month in 10 patients with initial suboptimal results. Success was defined as a reduction of pain score by at least 50%. RESULTS: All groups showed significant reductions in pain scores at all three follow-up visits. Success rates were higher in small joints (90% and 82%, respectively) than large ones (64% and 60%, respectively). Interestingly, IA PRF was successful in 6 out of 10 patients who had undergone previous surgery, including 3 with prosthetic joint replacement and in 6 of the 10 repeated procedures. There were no significant adverse effects or complications. CONCLUSIONS: IA PRF induced significant pain relief of long duration in a majority of our patients with joint pain. The exact mechanism is unclear, but may be related to the exposure of immune cells to low-strength RF fields, inducing an anti-inflammatory effect. The success rate appears to be highest in small joints. We recommend additional research including control groups to further investigate and clarify this method; our data suggest that it may represent a useful modality in the treatment of arthrogenic pain. Kowsar 2013-09-01 2013-09 /pmc/articles/PMC3833041/ /pubmed/24282777 http://dx.doi.org/10.5812/aapm.10259 Text en Copyright © 2013, Iranian Society of Regional Anesthesia and Pain Medicine (ISRAPM) http://creativecommons.org/licenses/by/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Schianchi, Pietro M Sluijter, Menno E Balogh, Susan E The Treatment of Joint Pain with Intra-articular Pulsed Radiofrequency |
title | The Treatment of Joint Pain with Intra-articular Pulsed Radiofrequency |
title_full | The Treatment of Joint Pain with Intra-articular Pulsed Radiofrequency |
title_fullStr | The Treatment of Joint Pain with Intra-articular Pulsed Radiofrequency |
title_full_unstemmed | The Treatment of Joint Pain with Intra-articular Pulsed Radiofrequency |
title_short | The Treatment of Joint Pain with Intra-articular Pulsed Radiofrequency |
title_sort | treatment of joint pain with intra-articular pulsed radiofrequency |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3833041/ https://www.ncbi.nlm.nih.gov/pubmed/24282777 http://dx.doi.org/10.5812/aapm.10259 |
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